Biomedical subjects

M E J Lean

Publications and source records attributed to M E J Lean.

22 records · Page 2Linked to original sources

PubMed2002

Effects of moderate weight loss on anginal symptoms and indices of coagulation and fibrinolysis in overweight patients with angina pectoris.

OBJECTIVE: To evaluate the effects of moderate weight loss, in overweight patients with angina, on plasma coagulation, fibrinolytic indicies and pain frequency. DESIGN: Single-stranded 12-week dietary intervention, an individualised eating plan with quantitative advice delivered by a dietitian. Target weight loss of 0.5 kg per week. SETTING: Outpatient research clinic. SUBJECTS: Fifty-four volunteers with angina pectoris were recruited. Five subjects withdrew, so 27 males, 22 females, mean body mass index (BMI) 29.3 (s.d. 4.3) kg/m(2) and age 60.3 (s.d. 6.5) y completed the intervention. MEASUREMENTS: Body weight and frequency of anginal pain. Plasma fibrinogen, red cell aggregation (RCA), viscosity, factor VII activity, plasminogen activator inhibitor (PAI) activity, tissue plasminogen activator antigen (t-PA), plasma cholesterol, triglyceride and insulin. RESULTS: After the 12-week dietary intervention period, mean body weight fell by 3.5 (s.d. 2.6) kg or 4.3% (P=0.0001), range -11.7 to +1.7 kg. Mean angina frequency fell by 1.8 (s.d. 3.6) from 3.2 to 1.4 episodes/week (P=0.009) and plasma cholesterol by 0.4 (s.d. 0.7) from 6.3 to 5.9 mmol/l (P=0.0001). HDL cholesterol and triglyceride were unchanged. Of the coagulation and fibrinolytic factors, factor VII activity and RCA were significantly reduced by 5 (s.d. 20), IU/dl (P=0.04) and 1.3 (s.d. 1.3) arbitrary units (P=0.014), respectively. CONCLUSIONS: A conventional dietetic intervention, resulting in 4% weight loss, offers the potential to reduce atherosclerotic and thrombotic risk, and to reduce pain frequency, in angina patients. Given the importance of this result in a public health context, these results indicate that this may be a fruitful area for future nutrition research.

Angina Pectoris↗

PubMed2002

Why lose weight? Reasons for seeking weight loss by overweight but otherwise healthy men.

OBJECTIVE: To identify the reasons for seeking weight loss in overweight or obese but otherwise healthy men. DESIGN: Interviews, prior to intervention, with subjects who had volunteered to participate in a work-site-based weight loss study. SUBJECTS: Ninety-one overweight/obese male workers. Mean age 41, range 18-55 y, mean body mass index (BMI) 31.0, range 26.2-41.6 kg/m(2). MEASUREMENTS: Anthropometric measurements; body weight and height. Body mass index calculated. A short interview using open questions to determine the individuals reason for seeking weight loss. RESULTS: The message that weight loss is beneficial to health for the overweight was recognized by all subjects regardless of BMI, and was reported as the main factor for attempting weight loss. Improved fitness and effects on appearance and well-being were reported half as often as the primary reason for weight loss. CONCLUSION: Overweight lay members of the public have accepted the health education message that weight loss can improve health. Overweight but otherwise healthy men who responded, of their own accord, to an electronic mail message offering help to lose weight did not regard obesity and overweight as primarily a cosmetic issue. This is still, however, important, especially to younger people. doi:10.1038/sj.ijo.0801999

Adolescent↗

PubMed2002

Weight management: a comparison of existing dietary approaches in a work-site setting.

OBJECTIVES: (1). To compare the effectiveness a 2512 kJ (600 kcal) daily energy deficit diet (ED) with a 6279 kJ (1500 kcal) generalized low-calorie diet (GLC) over a 24 week period (12 weeks weight loss plus 12 weeks weight maintenance). (2). To determine if the inclusion of lean red meat at least five times per week as part of a slimming diet is compatible with weight loss in comparison with a diet that excludes lean red meat. DESIGN: Randomized controlled trial. SETTING: Large petrochemical work-site. PARTICIPANTS: One-hundred and twenty-two men aged between 18 and 55 y. MAIN OUTCOME MEASURES: Weight loss and maintenance of weight loss. INTERVENTION: Eligible volunteers were randomized to one of the four diet/meat combinations (ED meat, ED no meat, GLC meat, GLC no meat). One-third of subjects in each diet/meat combination were randomized to an initial control period prior to receiving dietary advice. All subjects attended for review every 2 weeks during the weight loss period. For the 12 week structured weight maintenance phase, individualized energy prescriptions were re-calculated for the ED group as 1.4 (activity factor) x basal metabolic rate. Healthy eating advice was reviewed with subjects in the GLC group. All subjects were contacted by electronic mail at 2 week intervals and anthropometric and dietary information requested. RESULTS: No difference was evident between diet groups in mean weight loss at 12 weeks (4.3 (s.d. 3.4) kg ED group vs 5.0 (s.d. 3.5) kg GLC group, P=0.34). Mean weight loss was closer to the intended weight loss in the 2512 kJ (600 kcal) ED group. The dropout rate was also lower than the GLC group. The inclusion of lean red meat in the diet on at least five occasions per week did not impair weight loss. Mean weight gain following 12 weeks weight maintenance was +1.1 (s.d. 1.8) kg, P<0.0001. No differences were found between groups. CONCLUSIONS: This study has shown that the individualized 2512 kJ (600 kcal) ED approach was no more effective in terms of weight loss than the 6279 kJ (1500 kcal) GLC approach. However the ED approach might be considered preferable as compliance was better with this less demanding prescription. In terms of weight loss the elimination of red meat from the diet is unnecessary. The weight maintenance intervention was designed as a low-input approach, however weight regain was significant and weight maintenance strategies require further development.

Adult↗

PubMed2002

Weight change after myocardial infarction: statistical perspectives for future study.

OBJECTIVES: Survivors of acute myocardial infarction (MI) often experience weight changes and weight management is often appropriate. Estimates of the sample size required in intervention weight loss studies are essential to the success of future evaluations. The aims of this study were therefore two-fold: (1) to describe pilot data on the effectiveness of advice for weight loss; (2) to provide information on the sample size required for future research to assess weight management in similar patients. METHODS: Further analysis of data from a randomized controlled study carried out in 84 post-MI patients attending cardiac rehabilitation. Forty-three intervention patients received dietary advice in line with current UK guidelines. Additionally, overweight intervention subjects were given individualized weight management advice. Forty-two control patients were recruited and received usual care. Anthropometric measurements were made at baseline and followed up at 52 weeks post-rehabilitation. Power calculations were performed using these data to determine the required sample size to adequately power a study examining the effectiveness of weight management. RESULTS: Seventy patients completed the study. At 52 weeks anthropometric measurements were unchanged in the 25 overweight patients provided with weight management advice, and also for all those (n = 20) with body mass index <25 kg m-2. In contrast, anthropometric measurements increased significantly (body weight +2.4 kg, P = 0.02; waist circumference +2.6 cm, P = 0.008) in overweight control patients. A minimum sample size of 71 patients is required for a future study of weight change in overweight subjects, and 58 for a study of healthy weight subjects. CONCLUSIONS: Pilot data suggested that significant weight changes occur in patients not given nutritional or weight management advice after MI. Power calculations carried out on these data indicate that a sample size at least three times as large as the present study is required to accurately evaluate weight management in this group.

Adult↗